Phonomotor versus semantic feature analysis treatment for anomia in 58 persons with aphasia : a randomized controlled trial

PURPOSE : The ultimate goal of anomia treatment should be to achieve gains in exemplars trained in the therapy session, as well as generalization to untrained exemplars and contexts. The purpose of this study was to test the efficacy of phonomotor treatment, a treatment focusing on enhancement of phonological sequence knowledge, against semantic feature analysis (SFA), a lexical-semantic therapy that focuses on enhancement of semantic knowledge and is well known and commonly used to treat anomia in aphasia. METHOD : In a between-groups randomized controlled trial, 58 persons with aphasia characterized by anomia and phonological dysfunction were randomized to receive 56–60 hr of intensively delivered treatment over 6 weeks with testing pretreatment, posttreatment, and 3 months posttreatment termination. RESULTS : There was no significant between-groups difference on the primary outcome measure (untrained nouns phonologically and semantically unrelated to each treatment) at 3 months posttreatment. Significant within-group immediately posttreatment acquisition effects for confrontation naming and response latency were observed for both groups. Treatment-specific generalization effects for confrontation naming were observed for both groups immediately and 3 months posttreatment; a significant decrease in response latency was observed at both time points for the SFA group only. Finally, significant within-group differences on the Comprehensive Aphasia Test–Disability Questionnaire (Swinburn, Porter, & Howard, 2004) were observed both immediately and 3 months posttreatment for the SFA group, and significant within-group differences on the Functional Outcome Questionnaire (Glueckauf et al., 2003) were found for both treatment groups 3 months posttreatment. DISCUSSION : Our results are consistent with those of prior studies that have shown that SFA treatment and phonomotor treatment generalize to untrained words that share features (semantic or phonological sequence, respectively) with the training set. However, they show that there is no significant generalization to untrained words that do not share semantic features or phonological sequence features.Veterans Affairs Rehabilitation Research and Development Merit Review Grant C6572R.https://pubs.asha.org/journal/jslhrhj2020Speech-Language Pathology and Audiolog

Cross-modal generalization of anomia treatment to reading in aphasia

BACKGROUND : Generalization of treatment effects is the ultimate goal of therapy. However, treatment generalization across language modalities is not well understood in the aphasia literature and requires further investigation. This work examined the generalization effects of two word retrieval therapies, Phonomotor Treatment (PMT) and Semantic Feature Analysis (SFA), to reading performance in individuals with aphasia. AIMS : This cross-modal generalization investigation was motivated by the Primary Systems Hypothesis, which proposes reading ability is related to and dependent upon underlying phonological and semantic abilities. Therefore, this study sought to determine if enhanced phonological or semantic knowledge following anomia treatment could influence reading ability. METHODS AND PROCEDURES : Reading data collected in a randomized control trial for anomia treatment were retrospectively analyzed. Fifty-eight participants with chronic aphasia were randomly assigned to receive intensive PMT (n = 28) or SFA (n = 30) treatment for 56–60 hours over 6–7 weeks. Reading measures were administered pre-, post- and 3 months after treatment. To identify and compare the extent of treatment generalization to reading, within-group and between-group analyses of variance were performed. OUTCOMES AND RESULTS : On average, participants in both groups showed positive changes in reading. The PMT group demonstrated significantly improved reading of regularly and irregularly spelled words. The SFA group showed significant gains in reading of regularly spelled words and sentence-level reading comprehension. No statistically significant differences in oral reading or reading comprehension were found between the groups before or after therapy. CONCLUSIONS : These preliminary findings support the Primary Systems Hypothesis and suggest a link between reading ability and phonological and semantic abilities. Results show that one anomia treatment was not superior to the other and the positive influence of both PMT and SFA suggests that reading might be enhanced via intensively delivered treatments that focus on the underlying phonological or semantic impairment. Further investigations of cross-modal treatment generalization are needed to help better understand this relationship between word retrieval and reading and its implication for aphasia treatment.A Veterans Affairs Rehabilitation Research and Development Merit Review Grant.https://www.tandfonline.com/loi/paph202021-03-11hj2020Speech-Language Pathology and Audiolog

Effects of Phonomotor Treatment on Discourse Production

Background: Aphasia is an acquired language disorder that makes it difficult for people to produce and comprehend language, with all people with aphasia (PWA) demonstrating difficulty accessing and selecting words (anomia). While aphasia treatments typically focus on a single aspect of language, such as word retrieval, the ultimate goal of aphasia therapy is to improve communication, which is best seen at the level of discourse. Aims: This retrospective study investigated the effects of one effective anomia therapy, Phonomotor Treatment (PMT), on discourse production. Methods & Procedures: Twenty-six PWA participated in 60 h of PMT, which focuses on building a person’s ability to recognize, produce, and manipulate phonemes in progressively longer nonword and real-word contexts. Language samples were collected prior to, immediately after, and 3 months after the treatment program. Percent Correct Information Units (CIUs) and CIUs per minute were calculated. Outcomes & Results: Overall, PWA showed significantly improved CIUs per minute, relative to baseline, immediately after treatment and 3 months later, as well as significantly improved percent CIUs, relative to baseline, 3 months following treatment. Conclusions: PMT, which focuses on phonological processing, can lead to widespread improvement throughout the language system, including to the functionally critical level of discourse production

Phonomotor Versus Semantic Feature Analysis Treatment for Anomia in 58 Persons with Aphasia: A Randomized Controlled Trial

Purpose The ultimate goal of anomia treatment should be to achieve gains in exemplars trained in the therapy session, as well as generalization to untrained exemplars and contexts. The purpose of this study was to test the efficacy of phonomotor treatment, a treatment focusing on enhancement of phonological sequence knowledge, against semantic feature analysis (SFA), a lexical-semantic therapy that focuses on enhancement of semantic knowledge and is well known and commonly used to treat anomia in aphasia. Method In a between-groups randomized controlled trial, 58 persons with aphasia characterized by anomia and phonological dysfunction were randomized to receive 56–60 hr of intensively delivered treatment over 6 weeks with testing pretreatment, posttreatment, and 3 months posttreatment termination. Results There was no significant between-groups difference on the primary outcome measure (untrained nouns phonologically and semantically unrelated to each treatment) at 3 months posttreatment. Significant within-group immediately posttreatment acquisition effects for confrontation naming and response latency were observed for both groups. Treatment-specific generalization effects for confrontation naming were observed for both groups immediately and 3 months posttreatment; a significant decrease in response latency was observed at both time points for the SFA group only. Finally, significant within-group differences on the Comprehensive Aphasia Test–Disability Questionnaire (Swinburn, Porter, & Howard, 2004) were observed both immediately and 3 months posttreatment for the SFA group, and significant within-group differences on the Functional Outcome Questionnaire (Glueckauf et al., 2003) were found for both treatment groups 3 months posttreatment. Discussion Our results are consistent with those of prior studies that have shown that SFA treatment and phonomotor treatment generalize to untrained words that share features (semantic or phonological sequence, respectively) with the training set. However, they show that there is no significant generalization to untrained words that do not share semantic features or phonological sequence features

The influence of phonomotor treatment on word retrieval : insights from naming errors

PURPOSE : An increasing number of anomia treatment studies have coupled traditional word retrieval accuracy outcome measures with more fine-grained analysis of word retrieval errors to allow for more comprehensive measurement of treatment-induced changes in word retrieval. The aim of this study was to examine changes in picture naming errors after phonomotor treatment. METHOD : Twenty-eight individuals with aphasia received 60 hr of phonomotor treatment, an intensive, phoneme-based therapy for anomia. Confrontation naming was assessed pretreatment, immediately posttreatment, and 3 months posttreatment for trained and untrained nouns. Responses were scored for accuracy and coded for error type, and error proportions of each error type (e.g., semantic, phonological, omission) were compared: pre- versus posttreatment and pretreatment versus 3 months posttreatment. RESULTS : The group of treatment participants improved in whole-word naming accuracy on trained items and maintained their improvement. Treatment effects also generalized to untrained nouns at the maintenance testing phase. Additionally, participants demonstrated a decrease in proportions of omission and description errors on trained items immediately posttreatment. CONCLUSIONS : Along with generalized improved whole-word naming accuracy, results of the error analysis suggest that a global (i.e., both lexical–semantic and phonological) change in lexical knowledge underlies the observed changes in confrontation naming accuracy following phonomotor treatment.The Veterans Administration RR&D Merit Review Grant under grant number C6572R.https://pubs.asha.org/journal/jslhrhj2020Speech-Language Pathology and Audiolog